FDA Adverse Event Malfunction Summary report: N

O-ARM 1000 IMAGING SYSTEM

MDR report key: 6112822 · Received November 18, 2016

Report

Report Number
1723170-2016-03917
Event Type
Malfunction
Date Received
November 18, 2016
Date of Event
May 7, 2015
Report Date
November 18, 2016
Manufacturer
MEDTRONIC NAVIGATION, INC. (LITTLETON)
Product Code
OXO
PMA / PMN Number
K050996
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

NO PATIENT INFORMATION PROVIDED AS NO PATIENT WAS INVOLVED IN THIS CONCERN. A MEDTRONIC REPRESENTATIVE WENT TO THE SITE TO TEST THE EQUIPMENT. THE REPRESENTATIVE CONFIRMED THAT THE IMAGING SYSTEM SWITCH WAS DISLODGED. THE REPRESENTATIVE THEN RECONNECTED THE SWITCH. THE IMAGING SYSTEM THEN PASSED THE SYSTEM CHECKOUT AND WAS FOUND TO BE FULLY FUNCTIONAL. THIS EVENT WAS IDENTIFIED DURING A RETROSPECTIVE REVIEW AS DISCUSSED WITH THE FDA NEW ENGLAND DISTRICT OFFICE ON (B)(6) 2016 VIA MEDTRONIC NAVIGATION, INC. RESPONSE TO (B)(4). THIS REVIEW WAS PERFORMED AS A RESULT OF RECENT CHANGES/IMPROVEMENTS TO THE MEDTRONIC NAVIGATION, INC. MEDICAL DEVICE REPORT (MDR) REVIEW PROCESS AND IS FOR NON-ADVERSE EVENT REPORTABLE MALFUNCTIONS WITHIN THE LAST TWO YEARS WHERE THE REPORTED MALFUNCTION WAS NOT PREVIOUSLY ASSOCIATED WITH SERIOUS INJURIES. SIMILAR MALFUNCTIONS THAT HAD RESULTED IN SIGNIFICANT DELAYS OF SURGERY OR REQUIRED ADDITIONAL INTERVENTION HAD BEEN REPORTED AS MDR SERIOUS INJURIES. BASED ON THIS 483 OBSERVATION, THE REPORTING DETERMINATION HAS BEEN REVISED TO CONSIDER THESE MALFUNCTION EVENTS REPORTABLE. THIS PROCESS CHANGE RESULTED IN AN OVERALL INCREASE IN THE NUMBER OF MDRS FILED BY MEDTRONIC NAVIGATION, INC., SINCE (B)(6) 2016. IT SHOULD BE NOTED THAT THIS INCREASE IS NOT THE RESULT OF THE DISCOVERY OF NEW PRODUCT PROBLEMS, BUT RATHER THE RESULT OF A BROADER INTERPRETATION AND APPLICATION OF THE REGULATIONS WITHIN OUR PROCESSES.

Description of Event or Problem · 1

A MEDTRONIC REPRESENTATIVE REPORTED THAT THE IMAGING SYSTEM WAS NOT CHARGING AND THAT THE IMAGING SYSTEM SWITCH WAS DISLODGED. TROUBLESHOOTING CONFIRMED THAT NO LINE POWER WAS BEING PROVIDED FROM THE WALL SOCKET. NO ADDITIONAL INFORMATION WAS PROVIDED. THERE WAS NO PATIENT PRESENT WHEN THIS ISSUE WAS IDENTIFIED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
765685 O-ARM 1000 IMAGING SYSTEM IMAGE-INTENSIFIED FLUOROSCOPIC X-RAY SYSTEM, MOBILE OXO MEDTRONIC NAVIGATION, INC. (LITTLETON) BI-700-00027-120

Patients

Seq Age Sex Outcome Treatment
1